MP42-14 PI-RADS CATEGORIES ON INITIAL PROSTATE MRI ARE ASSOCIATED WITH ACTIVE SURVEILLANCE PROGRESSION IN PATIENTS WITH PROSTATE CANCER

Abstract

You have accessJournal of UrologyImaging/Radiology: Uroradiology II (MP42)1 Apr 2020MP42-14 PI-RADS CATEGORIES ON INITIAL PROSTATE MRI ARE ASSOCIATED WITH ACTIVE SURVEILLANCE PROGRESSION IN PATIENTS WITH PROSTATE CANCER Alex Z. Wang*, Luke P. O'Connor, Nitin Yerram, MD Jonathan Zeng, Sherif Mehralivand, MD Stephanie Harmon, PhD Amir H. Lebastchi, MD Michael Ahdoot, MD Siobhan Telfer, MD Patrick H. Gomella, MD Sandeep Gurram, MD Heather Chalfin, MD Naveen Nandanan, MD Peter L. Choyke, MD Maria J. Merino, MD Bradford J. Wood, MD Baris Turkbey, and Peter A. PintoMD Alex Z. Wang*Alex Z. Wang* More articles by this author , Luke P. O'ConnorLuke P. O'Connor More articles by this author , Nitin YerramNitin Yerram More articles by this author , Jonathan ZengJonathan Zeng More articles by this author , Sherif MehralivandSherif Mehralivand More articles by this author , Stephanie HarmonStephanie Harmon More articles by this author , Amir H. LebastchiAmir H. Lebastchi More articles by this author , Michael AhdootMichael Ahdoot More articles by this author , Siobhan TelferSiobhan Telfer More articles by this author , Patrick H. GomellaPatrick H. Gomella More articles by this author , Sandeep GurramSandeep Gurram More articles by this author , Heather ChalfinHeather Chalfin More articles by this author , Naveen NandananNaveen Nandanan More articles by this author , Peter L. ChoykePeter L. Choyke More articles by this author , Maria J. MerinoMaria J. Merino More articles by this author , Bradford J. WoodBradford J. Wood More articles by this author , Baris TurkbeyBaris Turkbey More articles by this author , and Peter A. PintoPeter A. Pinto More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000000891.014AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Active Surveillance (AS) is now a popular and well-accepted alternative to definitive therapy in patients with low-favorable to intermediate risk prostate cancer (PCa). Multiparametric MRI (mpMRI) is one of the tools frequently used to monitor progression in patients with CaP. Prostate Imaging Reporting & Data System (PI-RADS) scores are assigned to assess risk of clinically significant prostate cancer (csPCa). In this study, we investigate if PI-RADS scores are associated with AS progression for patients. METHODS: Our institutional database was queried for all patients who met criteria for active surveillance from 11/2003 to 5/2017. Criteria for inclusion included ≥ 2 mpMRIs, ≥ 2 prostate biopsies, and a diagnosis of prostate cancer. Patient demographics, mpMRI, biopsy and most recent follow-up data were recorded. PI-RADS categories on initial MRI were evaluated for eventual AS progression. RESULTS: 1709 patients were evaluated for prostate cancer at our institution. A total of 351 patients met the criteria for AS. 162 patients with PIRADS scores on initial MRI were selected. The average PSA at time of AS enrollment was 7.15 ng/mL (range, 0.06-96.76). 47/162 patients (29%) were recorded to have progressed on AS during this time. The median time to AS progression was 4.13 years (range, 0.05-10.4). Results are listed in Table 1. Of interest, 55/162 patients were found to have a PI-RADS 4 index lesion and 20/55 (36%) of these patients progressed on AS, with a mean time to progression of 4.12 years (IQR 2.53-5.84). A total of 19/162 patients were found to have a PI-RADS 5 index lesion and 9/19 (47%) of these patients progressed on AS with a mean time to progression of 2.22 years (IQR 1.55-2.01). On multivariable analysis, only PI-RADS category 4 or higher lesions (HR, 1.931; 95% CI, 1.037-3.595; p=0.04) were associated with progression on AS. CONCLUSIONS: PI-RADS category 4 lesions or higher on initial mpMRI can be used to predict progression of csCaP with patients on AS. Urologists should consider patients with PI-RADS 4 lesions high risk in any AS protocol and be monitored very closely. Source of Funding: N/A © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 203Issue Supplement 4April 2020Page: e609-e609 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.MetricsAuthor Information Alex Z. Wang* More articles by this author Luke P. O'Connor More articles by this author Nitin Yerram More articles by this author Jonathan Zeng More articles by this author Sherif Mehralivand More articles by this author Stephanie Harmon More articles by this author Amir H. Lebastchi More articles by this author Michael Ahdoot More articles by this author Siobhan Telfer More articles by this author Patrick H. Gomella More articles by this author Sandeep Gurram More articles by this author Heather Chalfin More articles by this author Naveen Nandanan More articles by this author Peter L. Choyke More articles by this author Maria J. Merino More articles by this author Bradford J. Wood More articles by this author Baris Turkbey More articles by this author Peter A. Pinto More articles by this author Expand All Advertisement PDF downloadLoading ...